Can you advise on how to lighten my hypertrophic burn from an incident 24-years ago? (Photo)

Question

I got 3rd degree burn on my face from an incident that happened when I was 3 (24 years ago). Looking to light the scar. I've done a few chemical peels which have help flatten it but the scar is darker than the rest of my skin and has a shiny layer which doesn't hold makeup.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

this is post inflammatory hyperpigmentation/melasma/discoloration that needs cosmelan or enlighten peels at home which we can do virtually and send to your home along with aerify peels regularly, vivatia foam, restorsea 10x, faith essence serum, and cosmelan 2 cream.

Hyperpigmentation from any type needs a combination approach of peels like cosmelan, enlighten and aerify,  lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, and constant skin care and sun protection.  Bimonthly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin.  If you have acne you can do additional treatments and peels to get more improvement.  I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.

Benjamin Barankin, MD, FRCPC · Answer

To treat this old burn scar, best to see an experienced and highly trained physician such as a dermatologist. There may be some topical lightening creams that would be helpful as well as medical-grade chemical peeling. I'd also be looking at doing laser resurfacing.

Laura Riehm, MD · Answer

Thank you for your question and posting a picture. It looks and sounds like you might have Post Inflammatory Hyperpigmentation (PIH). You can start by looking for prescription strength 4% Hydroquinone (HQ) to reduce the pigment. Do not buy it over the counter or off the internet. Laws vary by state. In Texas, physicians can prescribe and dispense in office. We have been very successful using the PicoSure laser with the FOCUS and / or Flat Lenses eliminating hyperpigmentation with a series of treatments. FOCUS lens treatments have the extra benefit of reducing the underlying scar tissue. This is one of our go to treatments for patients older than 40 and worried about the signs of aging. This laser is safe for all skin types. Start with sunscreen every day! Once you have treated your hyperpigmentation to your satisfaction, you will probably need a follow treatment every 6 to 12 months depending your level of re-pigmentation. Best of luck.

Can you advise on how to lighten my hypertrophic burn from an incident 24-years ago? (Photo)

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